Pauline Palopoli

Motivated professional eager to embrace new challenges. Demonstrates a strong work ethic, adaptability, and exceptional interpersonal skills. Proven ability to work independently and rapidly acquire new competencies.

Patient Care Coordinator - Southeast Alaska Regional Health Consortium - Juneau, Alaska

(2025-09 - 2026-04)

• Assured HIPAA compliance.
• Assisted in creating a positive environment for patients, family members, and staff by providing excellent customer service.
• Answered 50+ inbound calls while simultaneously checking patients in/out for cardiology, dermatology, neurology.
• Verify demographic and insurance information.
• Update changes and scan insurance cards to patients' chart.
• Assist patients in completing records release requests for continuity of care.
• Answer phones, return phone calls and respond to Artera messages.
• Educated patients on available health services and resources offered locally.
• Daily data monitoring to schedule patient follow-up appointments; coordinating with them to ensure labs and radiology orders have been completed prior.
• Initiate travel for patients via Aurora.
• Assist patients in portal creation via phone and in person in preparation for appointments.
• Patient portal resets ensured patients were able to keep their appointment.
• Coordinate with nurse case managers provider schedules.
• Reschedule patients due to inclement weather.
• Call patients daily to remind of next day appointment.
• Exceeded 80% fill rate weekly.
• Meditech ARM for referral management.
• Review referral queue daily and schedule accordingly, documenting communications with patients and action taken.
• Scan outside records to charts.
• Communicate to nurse case managers patient concerns via Tiger Text or patient chart.
• Respond promptly to emergency situations, following protocol.
• Participate in bi-weekly department meetings to provide feedback on improvements.
• Advocate for patients to ensure their needs were met timely.
• Sanitize wait room area daily.
• Other duties as assigned.

Authorization Specialist II - Southeast Alaska Regional Health Consortium - Juneau, Alaska

(2024-08 - 2025-09)

• Provide excellent customer service to all stakeholders.
• Capture and record inbound and outbound pre-certifications.
• Proofread orders ensuring accuracy of patient identifiers and CPT and ICD-10s.
• Submit incomplete orders to nurse case managers to correct and resubmit.
• Process pre-certification requests efficiently from start to finish using payor portals Availity, TriCare, Inovolon, One Health Port, Alaska Medicaid Health Enterprise.
• Processed an average 40 precertification requests daily, ensuring all clinical documentation was complete.
• Medical chart abstraction for precertification to Blue Shield Blue Cross and other payors.
• Document all determinations using standardized format.
• Track pending auths daily and update using internal systems.
• Receive and review denials.
• Inform providers and nurse case managers of denials from all insurance types to coordinate peer-to-peer reviews.
• Abstract records for peer-to-peer reviews.
• Keep departments and outside facilities abreast of pre-cert status regarding delays that could impact scheduled procedures.
• Attend weekly department meetings.

Accountant - Southeast Alaska Regional Health Consortium - Juneau, Alaska

(2021-02 - 2023-12)

• Create customer accounts using Lawson, QuickBooks and Workday.
• Update customer changes to accounts.
• Consistently met deadlines generating invoices for medical supplies, pre-employment drug screens, Covid testing, rent, travel expenses before month deadline.
• Post payments to accounts prior to established deadline.
• Reconciled accounts to ensure accuracy and compliance.
• Communicated to customers regarding late payments.
• Send delinquent accounts to collections.
• Manage long term care resident accounts by debit/credit accounts upon validating transactions.
• Credit accounts for all monies received.
• Correct discrepancies on accounts.
• Communicate with staff for questions such as requesting back-up documentation.
• Reconcile all accounts.
• Generate profit and loss reports monthly for each resident account.
• Generate customer aging reports.
• Post journal entries as needed.
• Enter credit memos on accounts.
• Respond to customer inquiries.
• Complete Engie accruals weekly.
• Complete positive pay daily.
• Discuss issues with accounts with assistant controller.
• Supported month-end closing activities through accurate documentation.
• Attend monthly close meetings.

Data Integrity Specialist HIM - Southeast Alaska Regional Health Consortium - Juneau, Alaska

(2019-12 - 2020-12)

• Maintained confidentiality of all patient information according to HIPAA regulations.
• Reviewed and validated requests for completeness before processing them.
• Leveraged computer software and technology to locate patient records.
• Use VACTRAK for immunization records as requested.
• Processed incoming and outgoing mail, emails, faxes, and phone calls related to release of information requests.
• Prepared correspondence notifying requestors when additional documentation is needed prior to releasing requested documents.
• Responded promptly and professionally to customer inquiries via telephone or email.
• Investigated discrepancies between requestor-provided authorization forms and actual patient record contents.
• Maintained positive working relationship with fellow staff, management and outside entities.
• Request patient records from archives.
• Assist in chart abstractions for audits.
• Identify incorrect diagnosis codes.
• Cancel FINS (Financial Identification Number).
• Identify provider coding deficiencies.
• Add addendums to existing provider notes.
• Create and merge encounters

Employability Assistance Caseworker (EA/GA) - Central Council Tlingit & Haida - Juneau, Alaska

(2015-10 - 2019-05)

• Use State of Alaska EIS and other interfaces to validate reported resources.
• Use Rite Track software to manage cases.
• Assessed client needs and developed personalized Self-Sufficiency Plans.
• Managed 60+ caseload.
• Built trust and rapport with clients to facilitate effective support.
• Processed payments and supportive services.
• Meet with clients each month to determine continued eligibility based on income guidelines.
• Documented case notes accurately in compliance with organizational policies.
• Conducted regular follow-ups to ensure client progress and satisfaction.
• Conducted home visits to assess client needs, evaluate progress toward goals, and document service delivery.
• Followed strict policies and procedures to maintain client confidentiality and keep data private.
• Responded promptly to phone calls from clients or referral sources seeking assistance or information about available resources.
• Developed relationships with local agencies to ensure access to necessary services for clients.
• Uploaded supporting documentation to client files.
• Supported families in navigating complex systems such as the court system or public benefits programs.
• Assessed clients' progress towards achieving established goals and objectives during treatment plan reviews.
• Collaborated with multiple agencies to coordinate services that would benefit the family.
• Conducted home visits to assess the safety of the family's living environment.
• Assisted families in identifying strengths, needs, and resources to increase their capacity for self-sufficiency.
• Testify as expert witness for the tribe in advocate capacity on behalf of the family.
• Research potential family placement for the child(ren)
• Apply state and federal policy to each case.
• Adhered to ethical principles and standards to protect clients' confidential information.

ICWA Family Specialist - Ketchikan Indian Community - Ketchikan, Alaska

(2014-01 - 2014-07)

• Supported families in navigating complex systems such as the court system or public benefits programs.
• Assessed clients' progress towards achieving established goals and objectives during treatment plan reviews.
• Collaborated with multiple agencies to coordinate services that would benefit the family.
• Conducted home visits to assess the safety of the family's living environment.
• Assisted families in identifying strengths, needs, and resources to increase their capacity for self-sufficiency.
• Testify as expert witness for the tribe in advocate capacity on behalf of the family.
• Research potential family placement for the child(ren)

TANF Case Worker - Central Council Tlingit & Haida - Juneau, Alaska

(2007-12 - 2013-10)

• Apply state and federal policy to each case.
• Adhered to ethical principles and standards to protect clients' confidential information.
• Explain program benefits, requirements to applicants.
• Verify all reported income to determine eligibility.
• Calculate monthly cash amount based on earned/unearned income and applying earned income deductions.
• Process monthly cash assistance and supportive services.
• Impose reduction of benefits for non-compliance.
• Draft written notification of changes to benefits and eligibility.
• Document all client interactions and actions on case.
• Conducted home visits to assess the safety of living environments for clients.
• Linked clients with social services, health care providers and governmental agencies to help claim or reclaim individual autonomy.
• Process quarterly ERF's (Eligibility Review Forms)
• Zero audit exceptions.
• Identify client strengths and weaknesses to develop Family Self-Sufficiency Plans.
• Participated in regular team meetings and in-house training sessions to boost group effectiveness.
• Provided referrals to appropriate health care providers or other community resources.

Associate of Science - Business Management - University of Alaska Southeast (2020-12)

Certificate - Accounting - University of Alaska Southeast (2020-12)